Cold Urticaria – Symptoms and Causes
Understanding Cold Skin Reactions
Cold urticaria causes skin to break out in itchy hives when exposed to cold temperatures. This reaction happens quickly, usually within minutes of cold exposure.
While some people experience mild symptoms, others may have severe reactions that can lead to dangerous drops in blood pressure, fainting, or even shock when swimming in cold water.
This condition appears most commonly in young adults.
If you think you might have cold urticaria, it’s important to see your doctor for proper diagnosis and treatment.
Management typically involves:
- Prevention Strategies: Avoid cold air and water when possible.
- Medication: Taking antihistamines before cold exposure.
- Protective Clothing: Wear layers when going out in cold weather.
- Medical Alert Jewelry: Informing others of your condition in case of an emergency.
Symptoms
Cold urticaria causes skin reactions when exposed to cold temperatures.
Common symptoms include:
- Itchy welts or hives on skin areas touched by cold
- Reactions that worsen as the skin warms up
- Swollen hands when holding cold items
- Swollen lips after eating or drinking cold things
Some people may experience more serious reactions such as:
- Full-body responses (anaphylaxis)
- Fainting
- Rapid heartbeat
- Swelling in limbs or torso
- Shock
- Swollen tongue and throat
- Breathing difficulties
Symptoms typically start shortly after skin contacts cold air or water. Wet and windy weather can make symptoms more likely to appear. Most reactions last about two hours.
The most dangerous reactions happen with full-body cold exposure, like swimming in cold water. These severe reactions could cause someone to lose consciousness, which is especially dangerous in water and could lead to drowning.
When to See a Doctor
Visit your doctor if you notice any skin reactions after being exposed to cold temperatures. This is important even for mild reactions, as your doctor needs to check for any possible underlying health issues.
Get emergency medical help right away if you have a severe reaction to cold that affects your whole body (anaphylaxis) or causes breathing problems. These symptoms require immediate attention.
Causes
The exact cause of cold urticaria remains unknown. Some individuals have skin cells that are highly sensitive to cold temperatures, which may be due to:
- Genetic factors
- Viral infections
- Underlying illnesses
When exposed to cold, the body of affected individuals releases histamine and other chemicals into the bloodstream. This chemical release triggers the characteristic hives and, in some cases, can lead to a whole-body reaction.
People with this condition have an abnormal immune response to cold stimuli, though researchers are still working to understand the precise mechanisms involved.
Risk Factors
You may be more likely to develop cold urticaria if:
You are in your teens or twenties. Young adults face higher chances of getting primary acquired cold urticaria, the most common type.
You have certain health issues. Secondary acquired cold urticaria can develop because of other medical conditions like hepatitis or cancer.
You have family history. In rare cases, cold urticaria runs in families. This hereditary form can cause painful welts and symptoms similar to the flu when exposed to cold temperatures.
Complications
Cold urticaria can lead to serious reactions when large parts of the body contact cold temperatures. Swimming in cold water is particularly risky, as it may trigger widespread hives and more dangerous symptoms.
People with this condition should take extra precautions before activities that involve cold exposure.
Ways to Prevent Cold Urticaria
To avoid another cold urticaria episode, take these preventive steps:
Before Cold Exposure:
- Take over-the-counter antihistamines ahead of time.
- Use all prescribed medications consistently.
- Test water temperature first by dipping a hand in before swimming.
Daily Precautions:
- Shield your skin from cold and sudden temperature changes.
- Avoid consuming ice-cold foods and drinks to prevent throat swelling.
- Keep your prescribed epinephrine injector (EpiPen, Auvi-Q) with you at all times.
Medical Situations:
- Inform your surgeon about your cold urticaria before any operation.
- This allows the surgical team to take necessary precautions in the operating room.
